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Question 1

___ __ is a committee that studies and make recommendations about hypertension in the US

Answer 1

JNC 7

Question 2

commonly known as the “silent killer” ______ results in a systolic BP greater than 140 mm Hg and a diastolic pressure greater than (0 mm HG

Answer 2

hypertension

Question 3

BP ranges

Answer 3

normal: 160/>100

Question 4

______ hypertension results from high BP from an unidentifibale cause

Answer 4

primary

Question 5

_____ hypertension is high BP with identified causes (caused by other diseases)

Answer 5

secondary

Question 6

______ is abnormal blood fat levels

Answer 6

dyslipidemia

Question 7

how is high BP viewed?

Answer 7

as a sign a risk factor for atherosclerotic cardiovascular disease or a disease

Question 8

BP = cardiac output x peripheral resistance

Answer 8

BP = cardiac output x peripheral resistance

Question 9

the elderly commonly have an increase in BP due to structural and functional changes. theses changes include ____________ and result in decreased elasticity of the major blood vessels?

Answer 9

accumulation of atherosclerotic plaque fragmentation of arterial elastins increased collagen deposits impaired vasodilation

Question 10

______ ______ hypertension is commonly seen in the elderly. It results in a greater systolic pressure (>140 mm Hg) and a normal diastolic pressure (

Answer 10

isolated systolic hypertension

Question 11

factors that influence development of hypertension?

Answer 11

increased SNS activity increased reabsorption of sodium chloride and H2O by kidneys increased activity of renin angiotensin system decreased vasodilation insulin resistance

Question 12

nonmodifiable risk factors for hypertension

Answer 12

genetics family history age

Question 13

modifiable risk factors of hypertension

Answer 13

smoking obesity physical inactivity dyslipidemia DM microalbuminuria or GFR

Question 14

symptoms of hypertension

Answer 14

no symptoms other than elevated BP symptoms related to organ damage are seen late and are serious (eye changes, renal damage, MI, cardiac hypertrophy, stoke)

Question 15

symptoms of potential organ damage?

Answer 15

angina SOB altered speech and vision headaches dizziness balance problems nocturia

Question 16

how do you assess for hypertension?

Answer 16

H & P exam of retinas labs (to identify organ damage) 12 lead ECG urine test 24 hr urine protein

Question 17

which labs may be done to assess hypertension?

Answer 17

analysis of Na, K+, creatinine, fasting glucose, total cholesterol, HDLs

Question 18

ways to reduce hypertension

Answer 18

weight loss reduced alcohol and sodium intake regular physical activity diet high in fruit, veggies, and low fat dairy DASH diet

Question 19

DASH diet (FYI)

Answer 19

grains: 7-8 servings/day veggies: 4-5 servings/day fruits: 4-5 servings/day lowfat/fat free dairy: 2-3 servings/day meat,fish,poultry:

Question 20

how long does it take for the taste buds to adapt to changes in salt intake?

Answer 20

2-3 months

Question 21

for pts with uncomplicated hypertension andn no specific indications for another med, what is the initial med?

Answer 21

thiazide diuretic

Question 22

s/s of thiazide diuretics

Answer 22

dry mouth thirst weakness/drowsiness electrolyte imbalance postural hypertension

Question 23

when is the best time to take thiazide diuretics?

Answer 23

in the AM

Question 24

________ _______ can occur if antihypertensive meds are suddenly stopped

Answer 24

rebound hypertension

Question 25

______ may be recommeded for the elderly re. hypertension. It will involve treatment with just one med, it will simplify the med regimen and make it less expensive

Answer 25

monotherapy

Question 26

Recommedations for follow up re. BP measurements

Answer 26

normal: recheck in 2 year prehypertension: recheck in 1 year Stage 1 hypertension: confirm w/in 2 months Stage 2 hypertension: evaluate or refer for care w/in 1 month *if >180/100 mm Hg evaluate and treat w/in 1 week

Question 27

_______ ______ is when BP >180/120 and must be lowered immediately to prevent damage to target organs

Answer 27

hypertensive emergency

Question 28

conditions associated with hypertensive emergency

Answer 28

hypertension of pregnancy acute MI dissecting aortic aneurysm intracranial hemorrhage

Question 29

therapeutic goals of hypertensive emergency

Answer 29

reduce BP 25% in 1st hr reduce to 160/100 over 6 hours then gradual reduction to normal over a period of days w/exception to ischemic stroke and aortic dissection * require frequent monitoring of BP and cardiac status

Question 30

meds for hypertensive emergency

Answer 30

IV vasodilators b/c they will have an immediate effect

Question 31

_______ ______ is when BP is very high but no evidence of immediate or progressive target organ damage

Answer 31

hypertensive urgency

Question 32

elevated BPs associated with severe_____, _______, or _____ are classified as urgencies

Answer 32

headache nosebleeds anxiety

Question 33

meds for hypertensive urgencies

Answer 33

fast acting oral agents (beta adrenergic blockers, ACE inhibitors, alpha2 agonist)